New end-of-year data from the National Institutes of Health show the continued decline of illicit drug and alcohol use among the country’s teens, even as the adult population struggles to cope with increases in binge drinking and opioid overdoses.

“It is encouraging to see more young people making healthy choices not to use illicit substances,” said National Drug Control Policy Director Michael Botticelli.

A yearly survey conducted by the NIH called Monitoring the Future surveys 8th, 10th and 12th graders anonymously across the country about their use of drugs. Overall, the results only bolster recent positive trends.

For example, the number of teens who reported consuming alcohol in the previous month has been steadily declining since the ’90s. This year, 7.3 percent of 8th graders, 19.9 percent of 10th graders and 33.2 percent of 12th graders claimed to have consumed alcohol in the past month.

Cigarette use has shown an even more precipitous decline among teenagers that continued this year. Only 2.6 percent of 8th graders, 4.9 percent of 10th graders, and 10.5 percent of 12th graders reported using cigarettes in the previous month.

That cigarette use has declined faster than alcohol use should not be much of a surprise, since adult use of tobacco has plummeted alongside the rates for teens over the same period. This may be attributed, in part, to large-scale public health efforts aimed at decreasing the prevalence of tobacco use in society.

Marijuana usage among teenagers, on the other hand, has held relatively steady in recent years, and that trend continued in 2016. According to the report, 5.4 percent of 8th graders, 14 percent of 10th graders, and 22.5 percent of 12th graders reported using marijuana in the past month.

The report does not speculate, but recent movements liberalizing marijuana laws may account for the differences between the trends for teens’ use compared to those for alcohol and tobacco.

But when it comes to other illicit drugs, teen use is actually quite low. According to the report, 12th graders admit to using the following drugs in the past year at quite low rates:

Hallucinogens — 4.3 percent

Synthetic marijuana —3.5 percent

MDMA (ecstasy) — 2.7 percent

Cocaine— 2.3 percent

Salvia — 1.8 percent

Inhalants — 1.7 percent

Amphetamines — 6.7 percent

Tranquilizers — 4.9 percent

Opioids other than heroin — 4.8 percent

Cough medicine — 4.0 percent

Sedatives — 3.0 percent

Abuse of the opiate painkiller Vicodin fell from 7.5 percent among 12th graders to 2.9 percent since 2012, showing a striking decline as similar rates for adults went up across the country.

While it’s obviously bad for any teens to use unhealthy drugs, these numbers show significant progress in the fight to educate children about these issues.

“Across all grades, past-year use of inhalants, heroin, methamphetamine, alcohol, cigarettes, and synthetic cannabinoids are at their lowest by many measures,” the NIH report notes.

Since the data rely on self-reported use rates, there’s room for skepticism about the accuracy of these numbers. However, students are told correctly that the surveys are entirely anonymous. And since the same style of survey has been used for decades, the trends we see in the data are likely meaningful, even if some portion of respondents is consistently dishonest.

“We must continue to do all we can to support young people through evidence-based prevention efforts as well as treatment for those who may develop substance use disorders,” said Botticelli. “And now that Congress has acted on the president’s request to provide $1 billion in new funding for prevention and treatment, we will have significant new resources to do this.”

“Clearly our public health prevention efforts, as well as policy changes to reduce availability, are working to reduce teen drug use, especially among eighth graders,” said Nora Volkow, director of the National Institute on Drug Abuse. “However, when 6 percent of high school seniors are using marijuana daily, and new synthetics are continually flooding the illegal marketplace, we cannot be complacent. We also need to learn more about how teens interact with each other in this social media era, and how those behaviors affect substance use rates.”

E-Cigarettes

One wrinkle in these findings is that while most drugs are losing popularity among youth, teens increasingly are turning to e-cigarettes. In fact, e-cigarette use outpaces traditional cigarette use among teens in every grade-level studied:

Surveys also found that teens may not be entirely clear on what is in their e-cigarettes. Only 24.9 percent of said they believed they were inhaling nicotine through their e-cigarettes, even though the vapor is very likely to contain the harmful drug.

According to a recent report from the Surgeon General, the use of e-cigarettes among teens has tripled since 2011. In 2010, it was virtually non-existent.

“Kids are a kind of ‘third rail’ issue” when it comes to e-cigarettes, explained Amy Fairchild, associate dean of academic affairs at the Texas A&M School of Public Health in a press release. “On the one hand, they require extra protections. On the other, though, we also have to place their risks of harm into perspective. The consequences of combustible tobacco use are well-known and serious, while e-cigarettes — while not risk free — represent a far lesser harm.”

The Food and Drug Administration requires buyers to be at least 18 to purchase e-cigarettes, though some states have additional regulations. In California, only those 21 and older can be purchasers.

Some public health experts are exploring ways to curb the growing trend.

“Taxation may represent a key strategy that can protect kids and still reduce overall harms,” said Fairchild. “Kids are extremely price sensitive. There is evidence to suggest that you can tax e-cigarettes and other less risky smokeless products out of their hands.”

There are some worries here: Accessibility of e-cigarettes may be helping to reduce the use of regular cigarettes, which may be more harmful in the long run. On the other hand, some researchers worry e-cigarettes may lead users to eventually pick up a traditional smoking habit.

Regardless of those effects, the nicotine in e-cigarettes itself can damage the brains of teenagers, according to the surgeon general.

“Still, it’s important to underscore that, as worrisome as the experimentation with e-cigarettes is, youth smoking continues to decrease,” Fairchild said

Progress for teens but not for adults

Despite a few caveats, the overall picture for drug use among adolescents is encouraging. However, with the exception of a continuing decline in cigarette use, the same cannot be said for adults.

In 2015, drug overdose deaths in the American population climbed to 50,000, the largest in modern times. This is largely due to a persistent opioid epidemic that wreaks devastation in countless communities and flummoxes public health advocates.

So while public health experts can recognize, and perhaps even claim some credit for, an increase in healthy habits for adolescents, the picture is less rosy for the rest of the population. The question the country faces now is: What are we doing right for teens that we’re getting wrong for everyone else?